Hospital-acquired infections

Hospitals in Missouri perform surveillance and external reporting for a number of hospital-acquired infections (HAI). We are required to do so variously by the stateof Missouri, the Centers for Medicare and Medicaid Services (CMS) and for those of us reporting to a Patient Safety Organization (PSO). Hospital-acquired infectionsare recognized as typically preventable with optimal infection prevention andcontrol practices. In the context of the National Quality Strategy required by the Affordable Care Act, reducing HAI is part of the priority of "Making care safer by reducing harm caused in the delivery of care.

Hospital readmissions

Hospital readmissions are under scrutiny in the context of health care delivery and payment reform. Hospital readmission rates for Medicare (CMS) patients with principal diagnoses of heart attack, heart failure and pneumonia are published to the consumer-focused Hospital Compare site as an "outcome of care" for hospitals participating in the InpatientQuality Reporting program. The CMS Hospital Readmissions Reduction Prorgam will first affect Medicare payment in federal fiscal year 2013. In year one, the focus is 30-day readmissions of patients with heart attack, heart failure and pneumonia. Hospitals with higher-than-predicted readmission rates between July 1, 2008, and June 30, 2011, will be subject to as much as a 1 percent payment reduction (1 percent reduction in base operating DRG payment amount for Medicare Fee for Service patients aged 65 or older) in October, 2012

Clostridium difficile infection : considerations for hospitalists

As hospitalists, we often care for patients who either present with diarrhea or develop diarrhea during their hospital visit. We have learned to think of Clostridium difficile infection (CDI) early. In the United States, administrative data demonstrated significant increases in hospitalized patients with CDI beginning in 2001.Includes bibliographical reference

Quality/Safety Section : Introducing the journal's quality/safety section

Quality/Safety Section. Contributor/Author : "Catherine Messick Jones"With this issue, we are launching a Quality/ Safety Section to focus on quality improvement, patient safety topics and methods important to Hospitalists.Includes bibliographical reference

Something has to change

"When you have the thought, 'Something has to change', what do you do? Often, the decision to change is prompted by a problematic or undesired outcome, or a process that is frankly broken. What change is required in order to solve the problem?"Kristin Hahn-Cover, Catherine Messick Jones (Division of Hospital Medicine, Department of Medicine, University of Missouri)Includes bibliographical reference

Evaluating Digital Stories as Authentic Evidence of Civic-Mindedness

Using the Civic-Minded Graduate and the Association of American Colleges & Universities VALUE Rubric, digital stories created by recipients of co-curricular service-based scholarship programs were analyzed to document authentic evidence of civic-mindedness. The findings indicate that: * Digital stories are an effective tool to capture evidence of civic learning. * Students showed high levels of civic identity on both rubrics. * The research increased understanding of the similarities and differences in terms of how the two rubrics measure civic learning and capture variance in civic-mindedness

What is the value of short? Exploring the benefits of episodic volunteer experiences for college students

This exploratory study is designed to understand the civic outcomes (e.g., civic-mindedness, intentions to volunteer in the future, and intentions to donate money in the future) for college students who participate in a “Day of Service”. Understanding civic outcomes for college student episodic volunteers helps to justify the investment of staff time devoted to planning and implementing short-term volunteer events by both campus and community-based organizations

Fluctuations of the Atlantic North Equatorial Undercurrent and associated changes in oxygen transports

Although the core velocity of the Atlantic North Equatorial Undercurrent (NEUC) is low (0.1−0.3 m s−1), it has been suggested to act as an important oxygen supply route towards the oxygen minimum zone in the eastern tropical North Atlantic. For the first time, the intraseasonal to interannual NEUC variability and its impact on oxygen are investigated based on shipboard and moored velocity observations around 5°N, 23°W. In contrast to previous studies that were mainly based on models or hydrographic data, we find hardly any seasonal cycle of NEUC transports in the central Atlantic. The NEUC transport variability is instead dominated by sporadic intraseasonal events. Only some of these events are associated with high oxygen levels suggesting an occasional eastward oxygen supply by NEUC transport events. Nevertheless, they likely contribute to the local oxygen maximum in the mean shipboard section along 23°W at the NEUC core position

Intention to Quit Smoking and Polytobacco Use Among College Student Smokers

Little is known about polytobacco use in college students. One nationally representative survey indicated 51.3% of tobacco-using college students used more than one product, which may increase risk of tobacco-related disease and premature death. The purpose of this study was to examine the association of intention to quit smoking (ITQS) cigarettes with polytobacco use status, controlling for frequency of tobacco product use and cigarette smoking intensity as measured by cigarettes per day (CPD). Data are from a larger quasi-experimental study conducted at a large state university in the Southeastern United States. Analysis is based on the combined sample of current smokers from two randomly selected cohorts surveyed two months apart. Polytobacco users (n = 52) were as likely as cigarette-only users (n = 81) to intend to quit smoking. Compared to students who used tobacco products 1–9 days per month, students using 10–29 days per month or daily reported higher ITQS. Higher intensity smokers (\u3e 10 CPD) were 71% less likely to indicate ITQS, compared to lower intensity smokers (≤ 10 CPD) (p = .025). College student polytobacco users were as likely as those using only cigarettes to intend to quit smoking. Interventions are needed to target college student polytobacco users as well as cigarette smokers as both groups may intend to quit. Smokers using 10 or fewer CPD and those who use tobacco products daily or 10–29 days per month may be more motivated to quit than college students who smoke with more intensity but who use tobacco products less frequently